• Gangrene

    (Dry Gangrene; Gas Gangrene; Organ or Tissue Death; Wet Gangrene)

    Definition

    Gangrene is the progressive death of body tissue resulting from a lack of blood supply and infection. When the blood supply is cut off, the tissue does not get enough oxygen and begins to die.
    Gangrene can be internal or external. The two most common types of gangrene are:
    • Dry gangrene—Lack of blood supply causes the tissue to die.
    • Wet gangrene—Usually occurs when the tissue is infected with bacteria from an injury. The tissue becomes moist and breaks down.
    A rare wet type called gas gangrene, develops from specific bacteria deep inside the body. Gas gangrene can be a result of surgery or trauma.

    Causes

    Gangrene is caused by infection or a reduced blood supply to tissues.

    Risk Factors

    Gangrene is more common in older adults.
    Other factors that may increase your chance of gangrene include:

    Symptoms

    External gangrene may cause:
    • Color changes, ranging from white, to red, to black
    • Shiny appearance to skin
    • Foul-smelling, frothy, clear, or watery discharge
    • Shedding off of skin
    • Severe pain followed by loss of feeling in the affected area
    Internal gangrene may cause:
    • Fever and chills
    • Confusion
    • Nausea and vomiting
    • Diarrhea
    • Lightheadedness or fainting, which may be caused by low blood pressure
    • Focal or diffuse pain
    If the gangrene is widespread, sepsis can occur.
    Gangrene of the Foot
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    Diagnosis

    You will be asked about your symptoms and medical history. A physical exam will be done.
    Your bodily fluids may be tested. This can be done with:
    • Blood tests
    • Tests of the discharge and the tissue
    Images may be taken of your bodily structures. This can be done with:

    Treatment

    Treatment of gangrene includes:
    • IV antibiotics—to treat infection
    • Debridement—surgical procedure to cut away dead and dying tissue, done to try to avoid gangrene from spreading
    • Supportive care, including fluids, nutrients, and pain medication to relieve discomfort
    • Blood thinners—given to prevent blood clots
    • Surgery may also be done to restore blood flow to the affected area
    • Amputation—removal of severely affected body part
    • Hyperbaric oxygen treatment—exposing the affected tissue to oxygen at high pressure may have some benefit

    Prevention

    To help reduce your chances of gangrene:
    • If you have chronic health conditions, follow the treatment plan outlined by your doctor.
    • If you have diabetes, inspect your feet every day for cuts, sores, or wounds.
    • Care for any cuts, sores, or wounds promptly to avoid infection.
    • If you need surgery, ask your doctor about taking antibiotics. This is especially true if you need intestinal surgery.

    RESOURCES

    American Diabetes Association http://www.diabetes.org

    Family Doctor—American Academy of Family Physicians https://familydoctor.org

    CANADIAN RESOURCES

    Diabetes Canada http://www.diabetes.ca

    Health Canada https://www.canada.ca

    References

    A quick summary of the 6 types of necrosis. Pathology Student website. Available at: http://www.pathologystudent.com/?p=5770. Accessed August 18, 2017.

    Clostridial myonecrosis. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T113907/Clostridial-myonecrosis. Updated October 1, 2014. Accessed August 18, 2017.

    Gangrene. Johns Hopkins Medicine website. Available at: http://www.hopkinsmedicine.org/healthlibrary/conditions/infectious%5Fdiseases/gangrene%5F134,151. Accessed August 18, 2017.

    Gangrene. NHS Choices website. Available at: http://www.nhs.uk/Conditions/Gangrene/Pages/Introduction.aspx. Updated October 13, 2015. Accessed August 18, 2017.

    Sepsis in adults. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T115805/Sepsis-in-adults. Updated July 28, 2017. Accessed August 18, 2017.

    Revision Information

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